A Review of Complementary and Alternative Treatments for Autism Spectrum Disorders

Table 3

Randomized controlled trials of noningestible complementary and alternative treatments for autism spectrum disorders (ASD).

Tx	Author, year	N, age,; % male	ASD type and DSM Dx	Tx info	Tx dose, duration	Control	Results
Massage	Field et al. 1997 [77]	22, M = 4.5; 54%	AD/Y	Given by staff at school	30 min/wk,; 4 wks	Attention (games)	ASD^1  𝑃<0.05; Repetitive behavior^4  𝑃<0.01; Social^5  𝑃<0.05
	Escalona et al. 2001 [78]	20, 3–6; 54%	AD/Y	Parent massage at bedtime	15 min/day,; 4 wks	Reading at bedtime	ADHD^1,2,4  𝑃<0.05; Repetitive behavior^4  𝑃<0.05; Social^4  𝑃<0.05; Improved sleep: sig^∗ ∗
	Silva et al. 2007 [79]	15, 3–6; 87%	AD/Y	Therapist 2x/wk; Parent: daily	15 min/day; 5 months	WL	Sensory^2  𝑃=0.01; ASD^2: ns; Social^2  𝑃=0.04; Language^2: ns
	Silva et al. 2009 [80]	46. 3–6; 80%	AD/N (eligible for AD services)	Therapist 2x/wk; Parent: daily	15 min/day; 5 months	WL	Social/commication^1,2  𝑃<0.01; ASD^2  𝑃<0.01; Sensory^2  𝑃=0.002
	Piravej et al. 2009 [81]	60, 3–10; 82%	AD/Y	SI Tx + massage; by therapist	2 hrs/week; 8 wks	SI Tx only	ADHD^1,2: ns; Disruptive behavior: ns^1, 𝑃=0.03^2; Sleep^2: ns; Anxiety^2  𝑃=0.01
		Allam et al. 2008 [83]	20, 4–7; 60%	AD/Y	Scalp acup + speech Tx	2x/wk speech; 40 min/wk acup; 9 months	Speech Tx only	ADHD^3  𝑃=0.21; Receptive language  𝑃=0.034^5, ns^5; Expressive langauge^5: ns
	Acupuncture	Wong and Sun 2010 [84]	50, 3–11; 88%	AD/Y	Tongue acup	5x/wk; 8 wks	Sham	Social^2,5: ns; Language^2,4,5: ns; Sensory^4: ns; Cognitive: ns^5, sig^3∗ ∗; Adaptive: sig^3∗ ∗
		Wong et al. 2010 [85]	55; 3–18; 85%	ASD/Y	Electro acup	3x/wk; 4 wks	Sham	Social: ns^2,3, 𝑃=0.01^2; Sensory^2: ns; Communication^2,3,5: ns; Receptive language^2,3: 𝑃<0.05; Repetitive behavior^2: ns; Cognitive^2: ns; Overall function^2  𝑃=0.003
	Animal assist	Bass et al., 2009 [105]	34, 4–10,; 85%	ASD/Y	Equine Tx	1 hour/wk; 12 wks	WL	Sensory^2  𝑃=0.002; ASD^2  𝑃=0.04
Music therapy	Buday, 1995 [99]	10, 4–9; 80%	AD/unk	Structured	5 sessions	Rhythm therapy	Communication^4 sig (in Tx session)
	Kim et al. 2008 [100]/Kim et al. 2009 [101]	20, 3–6; 100%	AD/Y	Music therapy; Improv; music therapy	30 min/wk; 12 wks	Play with toys	Social: ns^2,3, 𝑃=0.01^4; Social^4  𝑃<0.001 (in Tx session); Comply^4: 𝑃<0.01 (in Tx session)
	Neurofeedback	Pineda et al. 2008 [109]; Study 1	8, 7–17; 100%	ASD/N; (clinical dx)	↑ Mu suppression	90 min/wk; 10 wks	Sham	ADHD^5  𝑃<0.02; Sensory^2 sig^∗ ∗; Social^2: ns^∗ ∗; Communication^2: ns^∗ ∗
Pineda et al. 2008 [109]; Study 2		19, 7–17; 84%	ASD/N; (ADOS; ADI-R)	↑ Mu suppression	90 min/wk; 10 wks	Sham	Improvement in ADHD^5, social^2, and communcation^2; not stated if significant^∗ ∗; sensory not improved
Kouijzer et al. 2010 [110]		20, 8–12; 85%	ASD/Y	Excess ↓ theta	40 txs,; 6 months	No Tx	ASD: ns^1, ns^2, 𝑃<0.01^2; Communication: ns^1, 𝑃=0.02^2

Note: AD: Autistic Disorder, ASD: Autism Spectrum Disorder; DSM Dx: Y: yes (children diagnosed according to DSM-III or DSM-IV symptoms of ASD) and N: no (children not specifically diagnosed by DSM criteria; diagnosis method listed in parentheses); Tx: treatment; dx: diagnosis; ADOS: Autism Diagnostic Observation Schedule; ADI-R: Autism Diagnostic Interview Revised; wk: week; SI: sensory integration; acup: acupuncture; WL: Wait List; ns: nonsignificant; results superscripts indicate the method of assessment: ¹teacher/staff, ²parent, ³therapist/clinician, ⁴observation, ⁵psychometric/standardized testing; **significance values not included in the text. M: mean.